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Standard overturns decision to deny disabled Project Manager long-term disability insurance benefits after first Appeal

In addition to health insurance and other employee benefits his employer provided long-term disability insurance through Standard Insurance Company, based out of Portland, Oregon.

In 2010, Terry was forced to file a long-term disability claim with Standard Insurance Company (“Standard”) informing him that due to his debilitating disease he was no longer able to perform with reasonable continuity the Material Duties of his Own Occupation.

Soon after filing his disability claim Standard informed Terry that his claim was approved, which came as no surprise to him given the extent of his health issues.

Standard Terminates Long-term Disability Claim After 24 Months Claiming that the Disability was Due, In Part, to a Mental Disorder

The primary cause of Terry’s disability was and always had been type 2 diabetes and peripheral neuropathy. His pain had become so severe and had caused him to give up a successful career it was no surprise that Terry also began suffering acute depression symptoms related to the worsening of his physical state. Terry had also been diagnosed with bipolar disorder and anxiety, which complicated matters.

After paying his long-term disability claim for 24 months Standard informed Terry that it would no longer pay benefits beyond the 24 month period on account of his disability being “caused or contributed” to by a mental disorder. It was true that Terry suffered from mental illness, however, he had not claimed that depression nor any other mental illness was the sole or primary cause of his disability. Notwithstanding, Standard proceeded with the termination of Terry’s long-term disability claim on the grounds that his disability was caused or contributed to by a mental disorder. As part of their basis for denial, Standard cited the opinion of a hired medical consultant. That medical consultant attempted to minimize the extent of Terry’s physical disabilities while accentuating his mental disorders.

Following Submission of ERISA Administrative Appeal by Attorney Cesar Gavidia Standard Overturns Decision to Limit Long-term Disability Claim to 24 months

In response to Standard’s decision to terminate Terry’s long-term disability claim after 24 months, Attorney Cesar Gavidia and his appeal team began compiling the necessary evidence and implementing their plan of attack. Terry’s appeal served not only to detail and uncover all of the flaws and errors in Standard’s decision, but also to ensure a strong administrative record in the event that Standard decided to uphold its decision and the case were to proceed to federal court litigation.

Fortunately, a more expeditious and just result occurred. After receiving the appeal submitted by Attorney Gavidia and his appeal team, Standard overturned its decision and began paying benefits specifically for Terry’s type 2 diabetes, peripheral diabetic neuropathy and other physical complications.

Terry continues to receive monthly long-term disability insurance benefits from Standard while Attorney Gavidia continues to assist him with the ongoing and seemingly never-ending requests for health and status updates from Terry and his attending physicians.

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Standard

Standard insurance just dropped me with no communication with me.

Reviewed by D Larson on October 4th 2023 Verified Policyholder | June 2019 date of disability

I was put on Standard insurance by my employer in 2019. I was told by them when I was first on disability that I would be on this for the rest of my life. After 2 years of... read more >

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Sent on October 4th 2023 by Attorney Gregory Dell

I am sorry to hear about your experience. Do you currently have a denial letter from them that you can email to me?

Standard

Standard is one of, if not the worse, company in the industry now

Reviewed by Anonymous Erisa Victim on December 5th 2019 Verified Policyholder

The Standard changed after the company was acquired by Japanese based Meiji Yasuda Life Insurance Company in 2016 and subsequently being delisted from the US stock exchang... read more >

Standard

Standard is one of, if not the worse, company in the industry Standard hasn't approved or denied my claim in over a year. They keep promising to look at it 'next week'

Reviewed by S.B. on August 22nd 2019 Verified Policyholder

My husband is covered by a Standard STD/LTD non-ERISA plan. He has a very rare neuromuscular disorder and was hospitalized in intensive care, was off work for 6 weeks (wai... read more >

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Sent on August 22nd 2019 by Attorney Jay Symonds

S.B., this sounds extremely unusual and unreasonable, I suggest you contact our office and speak with one of the attorneys to address the specific questions you have re... read more >

Standard

I waited 5 weeks just to be told I can't receive benefits

Reviewed by Marissa on June 11th 2019 Verified Policyholder

After working overtime and stressing behind my job for the past 5 years, it resulted in me being diagnosed with retinopathy hypertension, at the age of 29, on 12/10/2018. ... read more >

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Sent on June 11th 2019 by Attorney Gregory Dell

Marissa, I am sorry to hear of your diagnosis and the troubles Standard is giving you. Please contact our office at once for a free consultation. We would love to speak... read more >

Standard

The Standard will threaten to withhold your pay until you sign every document that they send you. The worst part is when they consider back payment for SSDI benefits

Reviewed by Gena on December 10th 2017 Verified Policyholder

First of all, the worst thing that could ever happen to a hard-working person is a permanent disability. Fighting to secure payment is hard enough when you are well. Let a... read more >

Standard

Standard's sudden denial was inexplicable

Reviewed by Linda on September 13th 2017 Verified Policyholder

I was placed on disability by my doctor with a diagnosis of Cognitive Impairment (supported by both a neurologist and a neuropsychologist) which severely affects my abilit... read more >

Standard

Standard has keep me jumping through hoops for years

Reviewed by Donna on July 26th 2017 Verified Policyholder

I have been on LTD with The Standard since September 2011. The have had me jumping through hoops for all these years. Very rude if I call and ask a question. They say they... read more >

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Sent on July 26th 2017 by Attorney Stephen Jessup

Donna, please contact our office with a copy of the denial letter so we can discuss in detail how we may be able to assist you in appealing the denial.

Standard

Mental health LTD should be covered under the Mental Health Parity Act

Reviewed by Kim V. on February 10th 2017 Verified Policyholder

My company contracted with Standard for our short and long term disability policies. In Jan 2014 I was on STD, which turned into LTD with a waiting period, which was tough... read more >

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Answered Questions by Our Lawyers

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Showing 8 of 28 Answered Questions

Q: Do I have to pay back LTD after receiving SSDI?

Answered on September 21st 2023 by Attorney Gregory Dell

A: Hello. In most group disability policies there is offset language which states you must pay back any LTD that ... Read More >

Q: Non-taxable benefits have become taxable.

Answered on May 31st 2023 by Attorney Gregory Dell

A: I am sorry to hear what you are going through. We have seen you exact fact pattern with tax on ssdi when you w... Read More >

Q: How do I ensure Standard makes a timely decision with regard to my claim?

Answered on December 8th 2020 by Attorney Alex Palamara

A: Matthew, we are sorry to hear that you are having difficulty with your claim. While the insurance company does... Read More >

Q: Why can my employer hold my disability check after The Standard sends it to them? Can I file a grievance with them?

Answered on September 11th 2020 by Attorney Alex Palamara

A: Lucas, it sounds like your claim for STD benefits is under a policy that is self-funded by your employer. Thus... Read More >

Q: Should I contact you before submitting my application for a private disability benefit?

Answered on July 10th 2020 by Attorney Steven Dell

A: It is in your best interest to contact us as early as possible if you think you are going to need to file a lo... Read More >

Q: Is there any case law in which a state government employee LTD plan decided to drop the 24 month mental health limitation? Has there been any success against a state government and Standard using ADA Title I (employee) and 3 (insurance company) from a discrimination basis?

Answered on May 10th 2018 by Attorney Alex Palamara

A: Marie, thank you for your compliments on our website. We strive very hard to get as much information out there... Read More >

Q: How can Standard deny my claim and expect me to work when I am disabled?

Answered on March 30th 2018 by Attorney Rachel Alters

A: Debbie, unfortunately this situation occurs often as there are two different departments reviewing your claim ... Read More >

Q: I'm waiting to hear back about my appeal. Should I hire an attorney?

Answered on December 1st 2017 by Attorney Stephen Jessup

A: Pam, if an appeal has already been submitted there may be very little an attorney could do at this point until... Read More >

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Standard overturns decision to deny disabled Project Manager long-term disability insurance benefits after first Appeal

Terry had worked as a project manager for a large national health group earning over $85,000 annually, until type 2 diabetes left him disabled and suffering from peripheral diabetic neuropathy, severe chronic pain, fatigue and depression.In addition to health insurance and other employee benefits his employer provided long-term disability insurance through Standard Insurance Company, based out of Portland,... Read More >

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Keith G.

They were very professional with their responds and on time with keeping you inform about everything with your case. I would recommend My lawyer Stephen Jessup, he was on point with everything, thank you. You guys are awesome people to work with. God bless you guys.

Keith L.

I was not able to work as a physician for about 14 months due to neck/back issues. Even though I had 3 medical doctors explicitly state that I was not to work AT ALL as a physician at that time, New York Life (NYL) Disability Insurance denied my long term disability claim (which apparently they deny a high percentage of people similar to me- only they know why they do this to so many- I have my own suspicions). I was in pain from my medical issues and so frustrated with NYL considering I had many bills coming due. I then decided to call Dell Disability Lawyers. One of their attorneys, Alex Palamara, spoke to me on the phone right then to hear and understand my story and then offer ways he could help. Long story short, within a few months of me returning back to work, he was able to persuade NYL to pay me my long term disability claim. He (and his kind assistant, Tabitha) were always very helpful, informative, and available to me. I feel quite certain that NYL would NEVER have paid me what was appropriate based on my insurance agreement/ contract with them without the help of Alex. I highly recommend him/Dell Disability Lawyers. If you find yourself in a similar situation of disability insurance denial of your own personal/group policy, especially if you are a medical provider/physician like me, then consider contacting them for advice/direction PRIOR to appealing your claim on your own.

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Jay Symonds and his assistant, Sonia helped me tremendously. The insurance company that worked for my former employer did everything they could to make my life literally miserable. That all changed when I hired Jay. He and Sonia fought for my rights and forced the insurance company to pay what they should have.

If you have a disability claim hire Jay as if you go it alone the insurance company will screw you. Jay and Sonia will fight for everything you are entitled for. I couldn’t recommend them more highly.

Frank R.

I cannot say enough positive things about my experience with Dell Disability Lawyers. Attorney Stephen Jessup and Amanda offered an opportunity to provide clarity on a complex issue regarding my disability claim. Mr. Jessup offered advice on an offset to my claim after my insurance company asked for additional information from Social Security. With counsel from Mr. Jessup, I was able to address the outstanding issue with the Social Security office and provide my insurance company with the required documentation to address their concerns. Mr. Jessup always responded in a timely manner with expert advice and offered the opportunity for follow up. I strongly recommend Dell Disability Lawyers to those seeking legal counsel for disability matters.

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I have been able to help others as a soldier, a police officer, and a pharmacist. I needed help forcing the insurance company to keep their commitment to take care of me and my family. I called Dell. Alex, Tabitha, and their entire team were very compassionate, extremely patient, and extraordinarily knowledgeable. Many thanks Dell!

Samar A.

My husband had applied for Long Term Disability and was denied. We sought out Rachel Alters at Dell Disability Lawyers to help us with our appeal. Rachel and her team were so diligent and meticulous in every aspect of the process. The process was seamless, and we never had any doubts that she would get it done and that she did! We are forever grateful to Rachel and Catherine for all of their determination and tenacity to get us the outcome we needed and deserved.

We could not recommend better representation and are indebted to them for making us whole again. Thank you so much Rachel and team!

Jam

Alex Palamara is one of The Best lawyers in the world and Dell Disability Lawyers are the Best by Far. Alex and his Assistant Tabitha helped me get the compensation I needed for a Horrific Disabling heath condition I’ve been dealing with for over a year. Alex and his team were so professional and caring. They treated me like I was there own family. Alex Knowledge, Expertise and skills as a Lawyer is among the Best of the Best in his field and I would HIGHLY recommend that if you ever have any issues with any Insurance Company over your Disability issues, please don’t hesitate to seek out Dell Disability and Alex Palamara. They truly are Amazing and caring. Thank God for them. Outstanding Job Alex and Tabitha

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9 years ago when I had to apply for disability benefits from my private disability policy the insurance company ignored my inquiries until Dell and Schaefer represented me and I have received the benefits without interruption til my policy expired at age 65. I have appreciated not having to deal directly with the insurance company and having attorney Greg Dell and assistant Danielle Lauria handle all communications which included monthly progress reports. I thank them for their efforts on my behalf and highly recommend them to all those in need of disability benefits.

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I’m so thankful I chose to reach out to the attorneys at Dell. They have always been quick to respond to any and all questions I have had. The anxiety I had while dealing with Lincoln Financial on my own has decreased immensely since Alex and Danielle took my case. They were able to get my LTD denial reversed and I am so very grateful!

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